TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 103: Heart Failure Buttaro: Primary Care: A Collaborative Practice, 6th Edition MULTIPLE CHOICE 1. A patient experiencing heart failure with reduced ejection fraction will have which symptoms? a. Dyspnea and fatigue without volume overload b. Impairment of ventricular filling and relaxation c. Mild, exertionally related dyspnea d. Pump failure from left ventricular systolic dysfunction ANS: D
Heart failure with reduced ejection fraction results in pump failure from ventricular systolic dysfunction. Heart failure with preserved ejection fraction may have milder symptoms and is associated with impairment of ventricular filling and relaxation. 2. A patient who has been diagnosed with heart failure for over a year reports being comfortable
while at rest but experiences palpitations and dyspnea when walking to the bathroom. Which classification of heart failure is appropriate based on these symptoms? a. Class I b. Class II c. Class III d. Class IV ANS: B
Patients with Class II heart failure (HF) will have slight limitation of activity and will be NURoccurring SINGTBwith .COordinary M comfortable at rest with symptoms physical activity. Patients with Class I HF do not have limitations and ordinary physical activity does not produce symptoms. With Class III HF, less than usual activity will produce symptoms. With Class IV HF, symptoms are present even at rest and all physical activity worsens symptoms. 3. A patient who has Class II heart failure is taking an ACE inhibitor and reports a recurrent
cough that does not interfere with sleep or activity. What will the provider do initially to manage this patient? a. Assess serum potassium and sodium immediately b. Discontinue the ACE inhibitor and prescribe an ARB c. Provide reassurance that this is a benign side effect d. Withhold the drug and evaluate renal and pulmonary function ANS: C
Cough occurs in about 20% of patients who take ACE inhibitors and is not dangerous. The patient should be reassured that this is the case. If the cough is annoying, alternate therapy with an ARB may be considered. It is not necessary to evaluate electrolytes, renal function, or pulmonary function.
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